Mental Health Flashcards
Which medication has the best evidence for the treatment of adolescent depression?
A. Citalopram.
B. Fluoxetine.
C. Imipramine.
D. Paroxetine.
E. Venlafaxine.
B. Fluoxetine.
SSRIs have become the first-line therapy for depression because they are well tolerated, can be administered once a day, and have fewer adverse effects than TCAs
Citalopram - an SSRI. Causes dose dependent QT prolongation leading to arrhythmias.
Fluoxetine - SSRI with longest half-life, which decreases symptoms associated with abrupt discontinuation and promotes better compliance. Only Rx approved by US FDA for ages 8-17 and European Medicines Agency for children >= 8.
Imipramine -TCA. TCAs have unfavourable side effects, lethality in overdose and lack of positive efficacy trials. Not used as first line but can be used in adolescents who fail to respond to SSRIs.
Paroxetine - and sertraline are SSRIs and most potent blockers. Not labeled for use in children.
Venlafaxine - potent inhibitor of serotonin reuptake and, at higher doses, inhibitors of norepinephrine reuptake. Studies indicate no more effective than placebo.
What is most common psychiatric diagnosis in children and adolescents?
Anxiety disorders
5-18% of adolescents
